Health authorities will be given the power to suspend incompetent GPs as part of a government drive against poorly performing doctors.

Consultants could also lose their right to appeal directly to the health secretary against suspension in a wholesale reform of disciplinary procedures.

All doctors will be forced to submit to external monitoring of their work, including an annual appraisal.

Launching consultation on the proposals, health secretary Alan Milburn said he wanted to sweep away the current 'protracted, acrimonious and legalistic disputes that have cost the NHS a pretty penny'.

Chief medical officer Professor Liam Donaldson said the plans would create 'a single system that copes with all grades of doctors from hospital consultants to juniors, GPs and locums'.

Locums could be required to carry 'smartcards' giving hospitals a detailed career history.

NHS Confederation chief executive Stephen Thornton welcomed the moves to deal with poorly performing GPs, which he said would end the 'archaic, laborious and rarely used mechanism' of the NHS tribunal.

'On the occasions when it has been utilised, HAs report long delays, leaving doctors thought to be a danger to their patients free to practise.' The tribunal has struck off 20 GPs in the past three years.

HAs and trusts will be able to refer doctors suspected of bad practice to 'independent and impartial' assessment and support centres. The centres will decide if doctors can be retrained or advise employers and the General Medical Council if not.

Mr Milburn said he wanted to see the reforms in place 'over the next two or three years'. He denied his plans were a 'vote of no confidence' in the GMC's plans for regular checks on doctors' performance. The proposals would 'modernise and strengthen' self-regulation.

The charity Action for Victims of Medical Accidents called on the government to give patients a role. Chief executive Arnold Simanowitz said:

'What happens when a patient or an organisation like ours has a concern?

Who is going to do something about it?'

British Medical Association chair Dr Ian Bogle said there were 'many details in this report that the BMA would question, not least the abandonment of existing systems that have, when properly used, been effective'. He warned that procedures designed for 'a minority of doctors' could be seen as threatening all doctors, 'further lowering morale'.

Government figures show there are currently 29 consultants who have been suspended for more than six months.

The NHS is spending£2.6m on all live suspensions.

Supporting Doctors, Protecting Patients.

www.doh.gov.uk/cmoconsult.htm

How the assessment centres will work

Run jointly by the NHS and the medical profession.

Led by a medical director and board of governors with a lay chair.

Could clear the doctor, insist on retraining, refer serious cases to the General Medical Council.

Could demand a review from the Commission for Health Improvement and the NHS Executive if there were organisational problems.